Provider Demographics
NPI:1356323091
Name:FRATTARELLI, JOHN LESLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LESLIE
Last Name:FRATTARELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:407 ULUNIU ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2519
Mailing Address - Country:US
Mailing Address - Phone:808-262-0544
Mailing Address - Fax:808-262-3744
Practice Address - Street 1:407 ULUNIU ST
Practice Address - Street 2:SUITE 312
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2519
Practice Address - Country:US
Practice Address - Phone:808-262-0544
Practice Address - Fax:808-262-3744
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2008-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HI11090207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology